Aggressive low-density lipoprotein (LDL) cholesterol-lowering therapy is important
for high-risk patients. However, sparse data exist on the impact of combined aggressive
LDL cholesterol-lowering therapy in familial hypercholesterolemia (FH), particularly
on side effects to changes in plasma coenzyme Q10 and proprotein convertase subtilisin/kexin
type 9 levels. We enrolled 17 Japanese patients with heterozygous FH (12 men, 63.9
± 7.4 years old) with single LDL receptor gene mutations in a prospective open randomized
study. Permitted maximum doses of rosuvastatin (20 mg/day), ezetimibe (10 mg/day),
and granulated colestimide (3.62 g/day) were introduced sequentially. Serum levels
of LDL cholesterol decreased significantly by −66.4% (p <0.001) and 44% of participants
achieved LDL cholesterol levels <100 mg/dl. There were no serious side effects or
abnormal laboratory data that would have required the protocol to have been terminated
except for 1 patient with myalgia. Coadministration of ezetimibe and granulated colestimide
further lowered serum LDL cholesterol more than rosuvastatin alone without changing
plasma coenzyme Q10 and proprotein convertase subtilisin/kexin type 9 levels. In conclusion,
adequate introduction of this aggressive cholesterol-lowering regimen can improve
the lipid profile of FH.
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Article Info
Publication History
Published online: November 24, 2011
Accepted:
September 1,
2011
Received in revised form:
September 1,
2011
Received:
June 21,
2011
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
